ICD-10 Code H49.23 – Sixth [abducent] nerve palsy, bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H49.23 – Sixth [abducent] nerve palsy, bilateral
What it is
H49.23 identifies bilateral palsy of the sixth cranial nerve, also called the abducent nerve. It means both eyes have reduced ability to move outward, usually from weakness of the lateral rectus muscles.
Clinical signs
Typical findings include limited abduction in both eyes and horizontal diplopia, especially when looking to the side. Clinical features vary; refer to documentation.
When to use this code
Use this code when the provider documents bilateral sixth nerve palsy or bilateral abducent nerve palsy. It also fits cases described as bilateral ocular motor nerve weakness affecting outward gaze, if the note clearly supports that diagnosis. Check documentation if the laterality is unclear.
Do not use for
Do not use H49.23 for isolated unilateral sixth nerve palsy or for nonspecific diplopia without documented nerve palsy. Do not assign it when the record only mentions eye movement problems without confirming bilateral involvement.
Coding tip
Verify laterality carefully; bilateral documentation is required for H49.23.